What are some telltale signs that you or your child might need braces?
Some telltale signs that a child might need orthodontic treatment include:
– The child has a crossbite where the top teeth hit on the inside of the bottom teeth when biting.
– The top teeth are flared forward (overbite or overjet) and may be in danger of accidental fracturing.
– The bottom teeth are too far forward of the top teeth when biting (underbite).
– The front teeth do not touch when biting on the back teeth (anterior openbite).
– The teeth are excessively crowded or spaced.
Photo Credit: Dr. Stoess-Allen, Overcrowded Teeth
Photo Credit: Dr. Stoess-Allen, Overcrowded Teeth
Photo Credit: Dr. Stoess-Allen, Spacing
What is the right time to put braces on a child or teen?
The right time to start orthodontic treatment on a child or teen with either traditional braces or Invisalign clear aligners varies depending on the malocclusion (improper bite) that exists. Some children need to get started as early as age 6 or 7 and others may be able to wait until most or all of the permanent teeth are erupted around age 11 to 13. The timing is very dependent on the initial problem and the final treatment goals to be achieved to eliminate the malocclusion.
What are some of the most common concerns you hear from teens during an initial consultation?
- Am I ready to get started in orthodontic treatment now?
The answer to this question is variable depending on whether there is a need for immediate intervention (early treatment) or if it would be better to wait for most or all of the permanent teeth to erupt. It will depend on the present malocclusion (improper bite) to make that decision but it can easily be determined at the initial consultation.
- How long with the treatment last?
Depending on several factors such as whether all permanent teeth are present, some baby teeth and some permanent teeth are present and also the difficulty of achieving an excellent finish will determine the answer to this question. Treatment times can vary from 6 months to over 2 years taking into consideration the difficulty of the particular malocclusion (improper bite).
- Do I have to wear braces or can I use Invisalign clear aligners?
In my orthodontic practice, I am finding that the vast majority of my patients, whether they are 6 or 76 years old, can be treated orthodontically using Invisalign clear aligners versus braces. In today’s world of advanced technology, I am finding that a large majority of my patients are also very happy to hear that they do not have to wear braces but instead can achieve the excellent results that would historically have been achieved only with braces, now using Invisalign clear aligners.
- What foods will I have to avoid?
When wearing braces many types of foods need to be avoided that might dislodge the braces or wires. These foods include sticky, chewy and hard foods including certain types of breads, candies and popcorn, etc. When being treated with Invisalign clear aligners there are no foods that need to be avoided simply because you are able to remove the aligners to eat meals and additionally to brush and floss your teeth after eating.
- Will the braces or Invisalign aligners hurt?
It is often noted that for a few days after the placement of braces and wires the teeth become sore making it difficult to feel comfortable eating most foods other than very soft ones like soups, soft pastas, mashed potatoes, etc. This discomfort typically dissipates after the initial first few days. For my patients who wear Invisalign clear aligners, while they may experience very minor initial discomfort, the majority of them state that the discomfort is so very minor that it does not interfere with eating most any foods in their typical diet.
- How often do I need to come into the office for appointments?
For my patients who wear braces, I typically schedule their appointments every 8 to 10 weeks. For my patients who wear Invisalign clear aligners, I typically schedule their appointments every 10-12 weeks. The appointments might be similar but we find that there are more “emergency” visits with our patients who wear braces due to brackets that might dislodge from a tooth or a wire that might poke into their gum tissue. In cases like that, we need to see the patients more frequently.
- If I am a candidate for Invisalign clear aligners, how many hours do I need to wear them daily and how often do I change to a new aligner?
It is recommended that the Invisalign clear aligners be worn 20-22 hours daily to be most effective. In my practice, we stick to those guidelines. We recommend that the aligners be removed for eating meals and for brushing and flossing the teeth. Otherwise, they should be worn for the best final results to be achieved. The aligners are to be changed weekly (instead of the historic two weeks) which has reduced the treatment time for our patients.
What are some important health, hygiene + personal care tips for braces?
It is mandatory to brush and floss the teeth a minimum of twice daily. With braces and wires it is challenging to properly clean the entire surface area of each tooth since they are somewhat bulky and cumbersome causing it to be difficult to reach all tooth surfaces adequately. It doesn’t mean that it cannot be done but it is a time consuming task. If the teeth are not cleaned adequately and all plaque is not removed, it can lead to gum tissue inflammation, bleeding and swelling. Additionally, if the teeth are not cleaned well around the actual braces, the teeth can develop areas of decalcification which is a precursor to tooth decay (cavities). However, when using the Invisalign clear aligners, since they are removable, a patient can easily brush and floss their teeth so that the above mentioned issues can be completely eliminated.
Can you please share some examples of the different types of braces available today? How can someone determine what type is right for their child or teen?
There are many types of braces that are on the market today including traditional braces where the wires are individually tied into each brace, self-ligating braces where each brace has a gate that closes around the wire, varying types of removable and functional appliances and there are several brands of clear aligners such as the Invisalign clear aligners. Due to the fact that Align Technology (the makers of Invisalign aligners) has the most advanced technology in the world, I prefer these clear aligners to treat most all of my patients. Because I keep up with the continual progressive changes using the clear aligners taking advantage of advancements in technology, I have found that I am able to use the clear aligner product effectively for most everyone, children and adults.
I have been an orthodontist for over 25 years and because of the fact that they are able to use Invisalign clear aligners as opposed to braces, my patients are happier while going through orthodontic treatment in comparison to the time when I used braces exclusively. I would suggest that patients and parents discuss the pros and cons of the different orthodontic systems with their orthodontist to determine which might be best for them.
What are some of the lesser-known benefits of braces?
Some of the lesser-known benefits of orthodontic treatment include the fact that having straight teeth allows patients to improve and maintain the health of their teeth, gums and surrounding bone. It can be very difficult to maintain excellent health of crowded (crooked) teeth since it is nearly impossible to clean all surfaces. Another lesser known fact is that when the teeth do not occlude (touch together properly when biting) there can be problems with chewing food adequately which can result in digestive problems, TMJ (temporomandibular joint) symptoms such as clicking and popping of the jaw when opening and closing the mouth, frequent headaches, as well as facial and head muscular pain. Improper bites can also lead to clenching and grinding the teeth causing them to wear and flatten over time.
How, from an orthodontist’s perspective, would you say a healthy, beautiful smile can have a real, lasting impact on someone’s life?
Approximately 50-80% of us believe that a great smile is the most important feature when making a first impression. In my opinion, there is nothing more engaging or captivating in an individual than their smile. Smiles seem to be contagious and also appear to help promote self-confidence that is very valuable in all aspects of life. It has also been suggested that smiling promotes many health benefits. It gives me great joy to treat a patient who initially hides their teeth with their hand because they are embarrassed about the appearance of their teeth, to them beaming with a big beautiful smile at the end of their orthodontic treatment because they are proud to show the world.